Alabama can enforce law criminalizing gender-affirming care, court rules

Alabama’s ban on gender-affirming care for trans minors, which criminalizes health care providers who violate the law, can be enforced while a lawsuit against it proceeds, a federal appeals court ruled Thursday.

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A three-judge panel of the U.S. Court of Appeals for the 11^th Circuit ruled in August that the ban could be enforced, lifting a lower court judge’s injunction blocking it. The plaintiffs then appealed to the full 11th Circuit. The full circuit hasn’t heard the case yet, but the court issued a brief order Thursday saying the injunction would be lifted while the full court decides whether to grant the hearing, Bloomberg Law reports. The order didn’t offer any explanation.

Alabama was the second state to ban the treatment, including puberty blockers and hormones as well as surgeries (genital surgery is not recommended for minors anyway), and the first to provide for criminal penalties. Republican Gov. Kay Ivey signed the ban into law in April 2022, and families and doctors filed a lawsuit challenging it within days. The law makes it a felony to provide this care, and those convicted under it could be sentenced to up to 10 years in federal prison.

“Alabama’s transgender healthcare ban will harm thousands of transgender adolescents across the state and will put parents in the excruciating position of not being able to get the medical care their children need to thrive. The district court issued its preliminary order blocking the ban after hearing days of testimony from parents, doctors, and medical experts about the devastating impact of this ban and the lack of any medical justification for it," the lawyers representing the plaintiffs said in a statement condemning the 11th Circuit’s action. "Today’s ruling will hurt parents and children in the state."

The lawyers are from the Southern Poverty Law Center, the National Center for Lesbian Rights, GLBTQ Legal Advocates and Defenders, the Human Rights Campaign, and the law firms of King and Spalding LLP and Lightfoot, Franklin, and White LLC.

The suit argues that the law discriminates based on sex and should be subjected to heightened scrutiny under the Equal Protection Clause of the U.S. Constitution’s 14^th Amendment and that it violates parents’ long-standing right to make medical decisions for their children. The case is Boe v. Marshall, also known as Eknes-Tucker v. Ivey.

The 11^th Circuit’s August action led a lower court judge to lift her injunction against Georgia’s ban on hormone therapy for minors, as Georgia is in the same circuit. The U.S. Court of Appeals for the Sixth Circuit has lifted injunctions against the bans in Kentucky and Tennessee.

Twenty-two states have banned some or all gender-affirming care for trans minors, and lawsuits are pending against most of these bans. A court has struck down the ban in Arkansas, which was the first state to pass one, but that ruling is on appeal.

The trial court in the Alabama case, the U.S. District Court for the Middle District of Alabama, is set to hold a full trial this coming August.

Pictured: An Alabama Pride event and Gov. Kay Ivey with other state officials